Individual
DAVID RODNEY DOUGLAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
7321 11TH STREET, BLDG 570, HILL AFB, UT 84056
(801) 777-7011
(801) 777-0590
Mailing address
911 W 950 S, BRIGHAM CITY, UT 84302-3074
(435) 723-7976
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
931
WY
Other
Enumeration date
12/04/2006
Last updated
07/08/2007
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